Thyroid medication not right after giving birth

[KayAlexe]

Hi all, I've had an underactive thyroid for 10 years but since giving birth 9 months ago my Dr keeps upping, lowering and now reconsidering my medication again. I feel absolutely wiped from it all. Could anyone interpret my latest results for me? I feel like I need some guidance and would be very greatful. I'm on levothyroxine 100mg per day and T3 15mg per day.

Serum free T4 level: 8.2pmol/L (normal range l: 7.0 - 17.0)

Serum TSH level: 0.02 mu/L (normal range: 0.20 - 4.50)

Serum T3 level: 8.4 pmol/L (normal range: 3.5 - 6.5)

[Jazzw]

Hi KayAlexe

How do you do your blood tests? Do you take your thyroid medication before having the test or do you leave off your medication until after you’ve had the test?

[KayAlexe in reply to Jazzw]

Thanks for responding. I leave off taking the medication until after the blood test

[Jazzw in reply to KayAlexe]

OK. Thought I’d better just ask before writing a reply—thank you! 🙂

I suspect you’ve probably got Hashimoto’s as the root cause of your original hypothyroidism. Pregnancy and birth can cause havoc with thyroids—especially those under attack by autoimmune disease.

You aren’t terribly overmedicated at the moment—just a little. I think I’d fight the doctor on reducing your T3 dosage much further (though they’ll probably want to cos Levo is cheap and liothyronine rather less so—in the U.K. anyway). I think I’d instead suggest reducing your levothyroxine dosage if they insist in a dose reduction. That might seem counter-intuitive given that your FT4 is low in range but it’s probably low because you’re on T3–your body isn’t needing to keep hold of T4 to convert it to T3.

When you’ve been used to having liothyronine it can be blooming hard to adjust to having a reduction in dose.

What dosage were you on before it all started going a bit wonky?

[KayAlexe in reply to Jazzw]

This advise helps. I have a consultation next week and want to try be a bit more informed. Before I was pregnant I was stable on 100mg per day, T3 had been advised but I'd not committed to taking it. During pregnancy it didn't really need too much adjusting I went up to 150mg leveo. It seems after the levothyroxine coming down and then with the introduction of t3 its been a bit wavering and hard to get right

[Lalatoot]

KayAlexe how many hours did you leave between your last dose of t3 and the test? Knowing the number of hours will help folks interpret your result.

[KayAlexe in reply to Lalatoot]

Hi thank you for the advice, I took the last dose of T3 in the afternoon before the blood test which was at 9am

[Lalatoot in reply to KayAlexe]

So more than 12hours between your blood test and your last dose of the. In that case your FT3 result is a false low. It would be a little higher usually.Given that your FT3 is already well above range I would suggest a 5mcg or quarter tablet decrease in liothyronine.

Wait 8 weeks and then do bloods.

Some folks manage with a low ft4 when on combo, others need ft4 over halfway through the range. I would suggest that you look at your next set of blood results if you decrease lio and consider if you should then increase levo.

[SlowDragon Administrator]

On levothyroxine plus T3 we will almost always have very low or suppressed TSH

GP should not adjust dose of levothyroxine or T3 by TSH

Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

Do you normally split your T3 as 3 x 5mcg dose spread through the day

Good you took last 5mcg dose approx 8-12 hours before test

ESSENTIAL to test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

When were vitamin levels last tested

Presumably you have autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies

If not already on strictly gluten free diet.

Have you had coeliac blood test done

If not request testing for coeliac before considering trial on gluten free diet

[Anthea55]

Hi, I don't know if it's any help. Many years ago I saw a nutritional doctor. He mentioned that when you are pregnant the foetus takes the vitamins / minerals that it needs. This can leave the mother deficient. He had often seen mums who had had several pregnancies and had developed deficiencies. It was also useful to check vitamin & minerals in mums who develop post natal blues etc.

I just wonder if you have been left with deficiencies which you did not have before you were pregnant.